MEDICARE: KIRK STONE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	11474125	WI

General Provider Information

NPI Number	:	1972281830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRK STONE

Provider Business Mailing Address
First Line	:	6402 ODANA RD STE 302
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53719-1123
Country	:	US
Telephone Number	:	608-712-3917
Fax Number	:	608-583-9657

Provider Business Practice Location Address
First Line	:	6402 ODANA RD STE 302
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53719-1123
Country	:	US
Telephone Number	:	608-712-3917
Fax Number	:	608-583-9657

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2023
Last Update Date	:	03/11/2026

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Directions to “ KIRK STONE ” Practice Location

Language	Start Address	Practice Location

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